Prognostic importance of paratracheal lymph node
The preliminary diagnosis of malignancy with a differential diagnosis of metastatic melanoma versus metastatic adenocarcinoma was communicated to the bronchoscopist, and EBUS-guided FNA procedure was concluded; the paratracheal lymph node
was not sampled.
According to Im study, right paratracheal lymph node
enlargement was seen in (87%) of cases whereas our study showed (60 %) involvement.
A recent theory is that patients who require a preoperative tracheostomy have more advanced disease and may have a higher rate of occult paratracheal lymph node
metastasis and thus preoperative tracheostomy increases the risk of stomal recurrence.
The right paratracheal lymph node
was found to be the most frequent site of mediastinal node enlargement in adults (4).
A subsequent CT scan confirmed the finding and identified a swollen right paratracheal lymph node
The patient underwent a near-total thyroidectomy and left paratracheal lymph node
dissection and left modified radical neck dissection.
18]F-FDG-avid mediastinal lymph nodes, mediastinoscopy of the paratracheal lymph nodes
was performed and PH confirmed lymphadenitis granulomatosa non necroticans.
Additionally, the scan revealed multiple noncalcified nodules of both lungs with enlarged bilateral hilar and paratracheal lymph nodes
, lytic bone lesions, and multiple enhancing round lesions throughout the liver, suggesting metastatic involvement (FIGURE 2).
On autopsy, he was found to be muscular and heavily built, and had cardiomegaly, enlarged paratracheal lymph nodes
and pulmonary oedema.
A chest radiograph (Figure 1) showed pleural thickening in the region of the costophrenic sulcus, enlargement of the hilar and paratracheal lymph nodes
, and a mass in the right upper lobe.